AIM:To determine the effect of free serotonin concentrations in plasma on development of esophageal and gastric fundal varices. METHODS:This prospective study included 33 patients with liver cirrhosis and 24 healthy c...AIM:To determine the effect of free serotonin concentrations in plasma on development of esophageal and gastric fundal varices. METHODS:This prospective study included 33 patients with liver cirrhosis and 24 healthy controls. Ultrasonography and measurement of serotonin concentration in plasma were carried out in both groups of subjects. The upper fiber panendoscopy was performed only in patients with liver cirrhosis. RESULTS:The mean plasma free serotonin levels were much higher in liver cirrhosis patients than in healthy controls (219.0 ± 24.2 nmol/L vs 65.4 ± 18.7 nmol/L,P < 0.0001). There was no significant correlation be-tween serotonin concentration in plasma and the size of the esophageal varices according to Spearman coefficient of correlation (rs =-0.217,P > 0.05). However,the correlation of plasma serotonin concentration and gastric fundal varices was highly significant (rs =-0.601,P < 0.01). CONCLUSION:Free serotonin is significant in pathogenesis of portal hypertension especially in development of fundal varices,indicating the clinical value of serotonergic receptor blockers in these patients.展开更多
AIM:To examine the portal hemodynamics of gastric fundal varices (GV) without gastro-renal shunt (GRS), and to retrospectively investigate the effects of various kinds of treatment on eradication. METHODS: Ninety-four...AIM:To examine the portal hemodynamics of gastric fundal varices (GV) without gastro-renal shunt (GRS), and to retrospectively investigate the effects of various kinds of treatment on eradication. METHODS: Ninety-four liver cirrhosis patients at high- risk of GV were treated in our hospital and enrolled in this study. We retrospectively examined their characteristics, liver function, and portal hemodynamics of GV. We performed balloon-occluded retrograde transvenous obliteration (BRTO) at first. If it was not technically possible to perform BRTO, endoscopic injection sclerotherapy using α-cyanoacrylate glue (CA) or percutaneous transhepatic obliteration (PTO) was performed. RESULTS: Among the 94 patients, a GRS was present in 79 (84.0%), and absent in the remaining 15 (16.0%). The subphrenic vein was connected to the inferior vena cava as the drainage vein in 13 (86.7%) out of the 15 cases without GRS. We performed BRTO in 6 patients, CA in 4 patients and PTO in 5 patients. The eradication rate was 100% for each procedure, but the rate of early recurrence within 6 mo was 16.7% for BRTO, 50.0% for CA and 40.0% for PTO, respectively. CONCLUSION: We should examine the hemodynamics before treatment of GV irrespective of the existence of GRS. If this hemodynamic examination reveals that the drainage vein connects directly to the inferior vena cava in GV without GRS, BRTO may be an effective treatment for GV with GRS.展开更多
Background: Recent obstetrical practice tends to avoid the use of manual uterine fundal pressure (MUFP);however, data showed that MUFP is actually employed. We here attempted 1) to determine the obstetricians’ attitu...Background: Recent obstetrical practice tends to avoid the use of manual uterine fundal pressure (MUFP);however, data showed that MUFP is actually employed. We here attempted 1) to determine the obstetricians’ attitudes towards MUFP via questionnaire, and 2) to examine whether MUFP shortens the 2nd stage of labor, with the latter tested as a pilot study. Methods: A questionnaire-based study was carried out (n = 122) at meetings of Obstetrics on May 5, 2017. Then, we conducted a pilot case-control study from August 23 to September 6, 2020. Participants (n = 29) were divided into two groups;women who did and did not want MUFP;i.e., MUFP (n = 14) vs. (Non-MUFP) group (n = 15). Results: Of 122 doctors, 99.18% (121/122) used MUFP at cesarean section. 95.90% (117/122) of institutions used MUFP in spontaneous delivery. 95.08% (116/122) obstetricians considered MUFP effective and helpful. 85.24% (104/122) considered that MUFP should be employed after station +3. In the case control study, MUFP vs. Non-MUFP group showed the second-stage-duration of 58.5 (50.25 - 71.25) vs. 48 (39 - 59) minutes, without statistical significance (P = 0.101). However, importantly, MUFP, compared with Non-MUFP group, showed a significantly shorter duration from head visible on introitus (apparition) to delivery;i.e., 21.26 ± 7.32 vs. 30.13 ± 10.61 minutes (P = 0.014). Conclusions: MUFP is still used widely and MUFP shortened the duration of head apparition to delivery time. Larger-sample studies are needed to confirm the efficacy and safety of MUFP.展开更多
基金Supported by The Ministry for Science, Technology and Development of Republic of Serbia, No. 14501B
文摘AIM:To determine the effect of free serotonin concentrations in plasma on development of esophageal and gastric fundal varices. METHODS:This prospective study included 33 patients with liver cirrhosis and 24 healthy controls. Ultrasonography and measurement of serotonin concentration in plasma were carried out in both groups of subjects. The upper fiber panendoscopy was performed only in patients with liver cirrhosis. RESULTS:The mean plasma free serotonin levels were much higher in liver cirrhosis patients than in healthy controls (219.0 ± 24.2 nmol/L vs 65.4 ± 18.7 nmol/L,P < 0.0001). There was no significant correlation be-tween serotonin concentration in plasma and the size of the esophageal varices according to Spearman coefficient of correlation (rs =-0.217,P > 0.05). However,the correlation of plasma serotonin concentration and gastric fundal varices was highly significant (rs =-0.601,P < 0.01). CONCLUSION:Free serotonin is significant in pathogenesis of portal hypertension especially in development of fundal varices,indicating the clinical value of serotonergic receptor blockers in these patients.
文摘AIM:To examine the portal hemodynamics of gastric fundal varices (GV) without gastro-renal shunt (GRS), and to retrospectively investigate the effects of various kinds of treatment on eradication. METHODS: Ninety-four liver cirrhosis patients at high- risk of GV were treated in our hospital and enrolled in this study. We retrospectively examined their characteristics, liver function, and portal hemodynamics of GV. We performed balloon-occluded retrograde transvenous obliteration (BRTO) at first. If it was not technically possible to perform BRTO, endoscopic injection sclerotherapy using α-cyanoacrylate glue (CA) or percutaneous transhepatic obliteration (PTO) was performed. RESULTS: Among the 94 patients, a GRS was present in 79 (84.0%), and absent in the remaining 15 (16.0%). The subphrenic vein was connected to the inferior vena cava as the drainage vein in 13 (86.7%) out of the 15 cases without GRS. We performed BRTO in 6 patients, CA in 4 patients and PTO in 5 patients. The eradication rate was 100% for each procedure, but the rate of early recurrence within 6 mo was 16.7% for BRTO, 50.0% for CA and 40.0% for PTO, respectively. CONCLUSION: We should examine the hemodynamics before treatment of GV irrespective of the existence of GRS. If this hemodynamic examination reveals that the drainage vein connects directly to the inferior vena cava in GV without GRS, BRTO may be an effective treatment for GV with GRS.
文摘Background: Recent obstetrical practice tends to avoid the use of manual uterine fundal pressure (MUFP);however, data showed that MUFP is actually employed. We here attempted 1) to determine the obstetricians’ attitudes towards MUFP via questionnaire, and 2) to examine whether MUFP shortens the 2nd stage of labor, with the latter tested as a pilot study. Methods: A questionnaire-based study was carried out (n = 122) at meetings of Obstetrics on May 5, 2017. Then, we conducted a pilot case-control study from August 23 to September 6, 2020. Participants (n = 29) were divided into two groups;women who did and did not want MUFP;i.e., MUFP (n = 14) vs. (Non-MUFP) group (n = 15). Results: Of 122 doctors, 99.18% (121/122) used MUFP at cesarean section. 95.90% (117/122) of institutions used MUFP in spontaneous delivery. 95.08% (116/122) obstetricians considered MUFP effective and helpful. 85.24% (104/122) considered that MUFP should be employed after station +3. In the case control study, MUFP vs. Non-MUFP group showed the second-stage-duration of 58.5 (50.25 - 71.25) vs. 48 (39 - 59) minutes, without statistical significance (P = 0.101). However, importantly, MUFP, compared with Non-MUFP group, showed a significantly shorter duration from head visible on introitus (apparition) to delivery;i.e., 21.26 ± 7.32 vs. 30.13 ± 10.61 minutes (P = 0.014). Conclusions: MUFP is still used widely and MUFP shortened the duration of head apparition to delivery time. Larger-sample studies are needed to confirm the efficacy and safety of MUFP.
